FALL  2000 
Volume 5 / Number 3

2000 Wyeth-Ayerst Prescription Drug Benefit Cost & Plan Design Survey Report

The 2000 edition of PBMI's benefit design survey report is now available. This report is based upon data collected in late 1999. For the past three years, this survey has been sponsored by Wyeth-Ayerst Laboratories. Their assistance allows PBMI to improve the survey and report and distribute the report to a wider audience. Some of the highlights from this report include:

Coverage of oral contraceptives continues to increase. The percent of employers who cover oral contraceptives has increased from 55% in the 1998 report to 69% in the 2000 report. The reasons cited include state mandates, a desire to meet the needs of the beneficiary population, and the reevaluation of benefit philosophy given the recent inclusion of erectile dysfunction products, among others.

The use of three-tier formularies increased from 10% of formulary users in the 1999 report to 25% of formulary users in 2000. Given the emphasis placed on this feature by PBMs and managed care organizations, PBMI expects the use of this feature to continue to grow.

The average retail brand copayment increased by 14.2% from $11.27 to $12.87. Although this one-year change is significant, cost sharing increases are not keeping up with the rate of drug cost increases. Since 1995, the average brand copayment has increased by 32.8%. During this time drug costs are estimated to have increased by almost 80%.

Average retail pharmacy reimbursement changed little during the past year. Industry-wide brand drug reimbursement appears to be settling around AWP ­ 13% and $2.30 dispensing fee.

This report is available to you at no cost. Read about these issues and more. Please visit PBMI's website to order a copy of this year's survey report.

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